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Prevention and Treatment of Thrombotic and Hemorrhagic Complications in Patients Supported by Continuous-Flow Left Ventricular Assist Devices

  • Pharmacologic Therapy (W H W Tang, Section Editor)
  • Published:
Current Heart Failure Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to describe the current knowledge in prevention and treatment of thrombotic (pump thrombosis and ischemic stroke) and bleeding (gastrointestinal and hemorrhagic stroke) complications in patients supported by continuous-flow left ventricular assist devices (CF-LVAD).

Recent Findings

Left ventricular assist devices (LVADs) are now widely used for the management of end-stage heart failure. Unfortunately, in spite of the indisputable positive impact LVADs have on patients, the frequency and severity of complications are limitations of this therapy. Stroke, pump thrombosis, and gastrointestinal bleeding are among the most serious and frequent complications in these patients.

Summary

The balance between hemorrhagic and thrombotic complications in patients supported with CF-LVAD is difficult as most patients do not necessarily fit a “bleeder” or a “clotter” profile but rather move from one side to the other of the thrombotic/bleeding spectrum. Further research is necessary to better understand the risk factors and mechanisms involved in the development of these complications.

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Authors and Affiliations

  1. Advanced Heart Failure and Heart Transplantation Section, Spectrum Health, 330 Barclay Avenue NE, Suite 200, MC258, Grand Rapids, MI, 49503, USA

    Renzo Y. Loyaga-Rendon, Milena Jani, David Fermin, Jennifer K. McDermott, Diane Vancamp & Sangjin Lee

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  1. Renzo Y. Loyaga-Rendon
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  2. Milena Jani
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  3. David Fermin
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  4. Jennifer K. McDermott
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  5. Diane Vancamp
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  6. Sangjin Lee
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Correspondence to Renzo Y. Loyaga-Rendon.

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Renzo Y. Loyaga-Rendon, Melina Jani, David Fermin, Jennifer K. McDermott, Diane Vancamp, and Sangjin Lee each declare no conflicts of interest.

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This article is part of the Topical Collection on Pharmacologic Therapy

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Loyaga-Rendon, R.Y., Jani, M., Fermin, D. et al. Prevention and Treatment of Thrombotic and Hemorrhagic Complications in Patients Supported by Continuous-Flow Left Ventricular Assist Devices. Curr Heart Fail Rep 14, 465–477 (2017). https://doi.org/10.1007/s11897-017-0367-3

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